Oktenidin hidroklorür, klorheksidin diglukonat ve povidon iyodürün, santral ve periferik venöz kateter uygulamalarında antiseptik etkilerinin karşılaştırılması

Year 2016, , 16 - 22, 01.01.2016

Şule Eda Ersöz Akcan Akkaya Esra Koçoğlu Ümit Yaşar Tekelioğlu Abdullah Demirhan Murat Bilgi Hasan Koçoğlu

https://doi.org/10.5505/abantmedj.2016.94824

Abstract

GİRİŞ ve AMAÇ: Santral ve periferik venöz katater uygulamalarında oktenidin hidroklorür, klorheksidin diglukonat ve povidon iyodürün antiseptik etkilerinin karşılaştırılması amaçlandı. YÖNTEM ve GEREÇLER: Çalışmaya 18-65 yaş arası, 90 olgu alındı. Olgular randomize olarak 3 eşit gruba ayrıldı Cilt dezenfeksiyonu Grup 1 n: 30 ’deki hastalarda % 0,1 oktenidin hidroklörür, Grup 2 n: 30 ’deki hastalarda % 10 povidon iyodür,Grup3 n: 30 ’deki hastalarda ise %1,5 klorheksidin glukonat ile yapıldı. Antisepsi öncesi ve sonrası ciltten örnek sürüntü alındı. Önce sıvı besiyerinde sonra kanlı agar ve EMB besiyerlerinde 24-48 saat arası 37 °C’de 24 saat inkübe edilerek koloni sayımı yapıldı.BULGULAR: Grup1 oktenidin hidroklorür ’de 4 hastada %13,3 ,Grup 2 povidon iyodür ’de 5 hastada %16,7 ,Grup3 klorheksidin diglukonat ’de ise 2 hastada %6,7 üreme saptandı.TARTIŞMA ve SONUÇ: Santral ve periferik venöz kateter uygulamalarında oktenidin hidroklorür, klorheksidin diglukonat ve povidon iyodür antiseptik solüsyonları arasında antimikrobiyal etkinlik açısından anlamlı bir fark bulunmadı.

Keywords

Santral venöz kateterizasyon, periferik venöz kateterizasyon, antisepsi

Comparison of antiseptic efficacy of octenidine hydrochloride, chlorhexidine digluconate and povidone iodine for the applications of central and peripheral venous catheterisation

Abstract

The purpose of this study is to compare the antiseptic efficacy of octenidine hydrochloride, chlorhexidine digluconate and povidone iodine for the applications.METHODS: After approval of the ethics committee and informed 90 patients aged between 18-65 years were included in the study. The patients were randomly divided into three equal groups. Skin disinfection was performed. In the first group with 0.1% octenidine and in the second group with 10% povidone iodine, in the third group with 1.5% chlorhexidine gluconate. Samples were taken with the swabs from the skin before and after the skin antisepsis. The samples were applicated first in the liquid medium and then blood and EMB agar culture media. They were incubated for 24-48 hours at 37 ° C and colonies were counted after 24 hours.RESULTS: All groups were similar in terms of the demographic data. The positive results is seen as follows, 4 cases 13.3% were foundto be positive in the OHC group, 5 cases 16.7% in the PI group, 2 cases 6.7% in the CHG group DISCUSSION AND CONCLUSION: As a result, statistically significant difference was not found in terms of antimicrobial effectiveness of octenidine hydrochloride, chlorhexidine digluconate and povidone iodine for the applications of central and peripheral venous catheters.

Keywords

Central venous catheterization, peripheral venous catheterization, antisepsis

References

• 1. Henderson DK. Infections caused by percutaneous intravascular devices. In:Mandeli GL, Bennett JE, Dolin R (eds). Principles and Practice of Infectious Diseases. 6th ed. Philadelphia: ChurchillLivingstone Ine 2005;347 -62.
• 2. Polderman KH, Girbes ARJ. Central venous catheter use. Part 1. Mechanical Complications, Part 2. Infectious complications.Intensive Care Med 2002;28:1-28.
• 3. Seneff MG: Central venous catheters. Dn:Irwin RS, Rippe JM, Curley FJ , Heard SO (eds) Procedures and techniques in intensive care medicine. New York, Little, Brown and company.1995;5- 36.
• 4. Mermel LA, Farr BM, Sherertz RJ, et al. Guidelines for the management of intravascular atheter-related infections. Infect Control Hosp Epidemiol 2001; 22: 222-42.
• 5. Afif C, Raad II. Intravascular catheter-related infections. In: Schlossberg D (ed). Current Therapy of Infectious Disease. 2nd ed. St. Louis: Mosby, 2001:416-8.
• 6. Dettenkofer M , Wilson C, Gratwohl A, Schmoor C, Bertz H, Frei R, Heim D, Luft D, Schulz S, Widmer AF. Skin disinfection with octenidine dihydrochloride for central venous catheter site care: a double-blind, randomized, controlled trial; Clin Microbiol Infect 2010; 16: 600–6.
• 7. Dettenkofer M, Jonas D, Wiechmann C. et al. Effect of skin disinfection with octenidine dihydrochloride on insertion site colonization of intravascular catheters. Infection 2002; 30(5): 282-5.
• 8. Tietz A, Frei R, Dangel M, et al. Octenidine hydrochloride for the care of central venous catheter insertion sites in severely immunocompromised patients. Infect Control Hosp Epidemiol 2005;26(8):703-7.
• 9. Krishna BV, Gibb AP. Use of octenidine dihydrochloride in meticillinresistant Staphylococcus aureus decolonisation regimens: a literature review. J Hosp Infect 2010; 74(3): 199-203.
• 10. Hanazaki, K, Shingu, K, Adachi, W, Miyazaki, T, Amano, J. Chlorhexidine dressing for reduction in microbial colonization of the skin with central venous catheters: Chlorhexıdıne Versus Povıdone-Iodıne J Hosp Inf 1999; 42, 166- 8.
• 11. Kinirons, B, Mimoz, O, Lafendi, L, Naas, T, Meunier, JF, Nordmann, P. Chlorhexidine versus povidone-iodine in preventing colonization of continuous epidural catheters in children: A randomized, controlled trial. Anesthesiology 2001;94, 239-44.
• 12. Maki DG, Ringer M, Prospective randomized trial of povidone-iodine, alcohol, and chlorhexidine for prevention of infection associated with central venous and arterial catheters. Lancet 1991;338, 339-43.
• 13. Garland, J.S, Alex, C.P, Mueller, C.D, Otten, D, Shivpuri, C, Harris, MC, et al. A randomized trial comparing povidoneiodine to a chlorhexidine-impregnated dressing for prevention of central venous catheter infections in neonates. Pediatrics 2001, 107, 1431-36.
• 14. Garland, J.S, Buck, R.K, Maloney, P, Durkin, D.M, TothLloyd, S, Duffy, M, et al. Comparison of 10% povidoneiodine and 0.5% chlorhexidine gluconate for the prevention of peripheral intravenous catheter colonization in neonates: Pediatr Infect Dis J 1995;14: 510-6.
• 15. Maki DG, Weise CE, & Sarafin HW A semiquantitative culture method for identifying intravenous catheter-related infection. N Engl J Med, 1997;296, 1305-9.
• 16. Mimoz, O, Pieroni, L, Lawrence C, Edouard, A, Costa,Y, Samii, K, & BrunBuisson, C. Two antiseptic solutions for prevention of central venous or arterial catheter colonization and infection in intensive care unit patients. Crit Care Med 1996;24, 1818- 23
• 17. Cobb DK, High KP, Sawyer RG. A controlled trial of scheduled replacement of central venous and pulmonary-artery catheters. N Engl J Med 1992; 327:1062-8 .
• 18. Norwood SH, Cormier B, McMahon NG et al. Prospective study of catheterrelated infection during prolonged arterial catheterization. Crit Care Med 1988; 16: 836-9.
• 19. Hnatiuk OW, Pike J, Staltzfus D, et al. Value of bedside plating of semiquantitative cultures for diagnosis of central venous catheter-related infections in ICU patients. Chest 1993; 103: 896-9.
• 20. Chaiyakunapruk, N, Veenstra, D.L, Lipsky, B.A. Chlorhexidine compared with povidone-iodine solution for vascular catheter-site care: Ann Intern Med 2002;136, 792-801
• 21. Atahan K, Cokmez A, Bekoglu M, Durak E, Tavusbay C, Tarcan E. The effect of antiseptic solution in central venous catheter care. Bratisl Lek Listy., 2012;113(9):548-51
• 22. Humar A, Ostromecki A, Direnfeld J, Marshall J C, Lazar N, P.C Houston, Boiteau P, Conly J.M. Povidone-Iodine versus Chlorhexidine as Cutaneous Antisepsis for Prevention of Central Venous Catheter Infection. Clin Infect Dis 2000;31:1001–7
• 23. Parienti JJ, Damien C, Michel R, Malbruny B, Leclercq R. Alcoholic povidone-iodine to prevent central venous catheter colonization: Crit Care Med 2004;2 Is 3 708-13200
• 24. Vallés J, Fernández I, Alcaraz D, Chacón E, Cazorla A, Prospective Randomized Trial of 3 Antiseptic Solutions for Prevention of Catheter Colonization in an Intensive Care Unit for Adult Patients . Infect Control Hosp Epidemiol 2008;29(9):847-53
• 25. Sedlockl D.M , Bailey D.M Microbicidal Activity of Octenidine Hydrochloride, a New Alkanediylbis[Pyridine] Germicidal Agent Antımıcrobıal Agents And Chemotherapy, 1985,786-90
• 26. Rabih O. Darouiche, Matthew J. Wall, Jr., Kamal M.F. Itani, ,Mary F. Otterson, Chlorhexidine–Alcohol versus Povidone–Iodine for Surgical-Site Antisepsis. N Engl J Med 2010;362:18-26.
• 27. Maiwald M, Chan ESY The Forgotten Role of Alcohol: A Systematic Review and Meta-Analysis of the Clinical Efficacy and Perceived Role of Chlorhexidine in Skin Antisepsis. PLoS ONE 2012;7(9): e44277.